Prevalence of Depression, Anxiety and Cognitive Impairment in Patients with Type 2 Diabetes from the Central Part of Romania

Simona Cernea^1,2, Cristian Zoltai³, Daniela Berbecilă⁴, Floredana-Laura Şular^5,6

1 Department M3/Internal Medicine IV, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Tîrgu Mureş, Romania
3 1st Psychiatry Clinic, County Clinical Hospital, Tîrgu Mureş, Romania
4 General Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
5 Central Laboratory, Emergency County Clinical Hospital, Tîrgu Mureş, Romania
6 Department M2/Laboratory Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.1515/amma-2016-0014

Objective: The aim of this study was to assess the prevalence of depression, anxiety and cognitive impairment in patients with type 2 diabetes (T2D).
Material and methods: We conducted a cross-sectional study in patients with T2D. Depression and anxiety were assessed by questionnaires (PHQ-9, CES-D and GAD-7 respectively), cognitive function by the MoCA test. Additionally, 503 patients’ clinic charts were separately analyzed in order to compare the data recorded in the charts with that resulted from the active assessment.
Results: In the screening study 216 subjects with T2D were included (62.2 ± 7.8 years old). 34.3% of them had depression and 7.4% presented major depression. 44.9% of patients with T2D had anxiety (9.2% major anxiety) and this was highly correlated with depression (OR: 21.139, 95%CI: 9.767-45.751; p<0.0001). Women had significantly higher prevalence of depression and anxiety compared to men (42.1% vs. 21.7%; p: 0.0021 and 51.1% vs. 34.9%; p: 0.02), but severe depression was similar between genders (9.0% vs. 4.8%; p: 0.29). Significantly more patients had depression and anxiety than recorded in their charts (34.3% vs. 13.9% and 44.9% vs. 9.3%,respectively; p<0.0001 for both). 69.0% of T2D patients had mild, 6.0% had moderate and none had severe cognitive dysfunction, respectively. Significantly more patients with depression and anxiety had mild and moderate cognitive impairment (p: 0.03 and p: 0.04, respectively).
Conclusions: Patients with T2D had a high prevalence of comorbid depression, anxiety and cognitive impairment. Depression and anxiety were significantly more frequent in women. These conditions were under-evaluated and/or under-reported.